Inside Health

LETTER; McCain's Health Care Plan

Published: November 1, 2008

To the Editor:

In ''Ceding the Center'' (column, Oct. 26), David Brooks says that John McCain has ''a good health care plan that was never fully explained.''

Mr. McCain has proposed a disastrous plan that most experts agree would destroy the tax-exempt employment-based insurance system and leave employees on their own to shop for whatever private insurance they could afford, supported by a tax credit of only $2,500 for an individual or $5,000 for a family.

The average current cost of decent private plans is more than double those amounts and is very likely to increase rapidly over the next four years.

Mr. McCain claims that individuals should be able to shop for insurance bargains, which would bring the cost of premiums down. Anyone who understands how the private health insurance industry operates would know that this is not a workable idea. Individuals have little or no consumer bargaining power, and insurers have no incentive to sell insurance to those most likely to need coverage.

The McCain plan would very probably increase, not decrease, the ranks of the uninsured and the underinsured.

Marcia Angell

Cambridge, Mass., Oct. 27, 2008

The writer, a medical doctor, is a senior lecturer in social medicine at Harvard Medical School and a former editor of The New England Journal of Medicine.